Before starting any exercise program, it is important to meet with your doctor for
a complete physical exam. Ask your doctor if there are any particular medical problems
you have that may affect your fitness program. If you do, work with your doctor to
develop a safe exercise program.

It is important to remember to start slowly. It might have taken you a long time to
get out of shape and it will take some time to get back into shape! Take it slowly
and don't get discouraged.

There are lots of ways to exercise aerobically. If you are just getting back into
exercise, a good place to start is with a walking program. Purchase a pedometer at
your local sporting goods store. This device attaches at your waist and tells you
how many steps you have taken. Start by seeing how many steps you take in a regular
day. Gradually add more steps to your daily activity. Easy ways to increase your steps
include:

parking further away from building doors

taking the stairs instead of elevators

walking up escalators

Once you have begun increasing your steps, gradually work toward a goal of 10,000
to 15,000 steps per day. To do this you will need to plan time to walk for exercise.
Walking a half mile every other day is a good start. As this becomes easier, try
walking every day. When you are ready to increase your distance, be sure not to increase
it more than a half mile at a time. This will help prevent overuse syndromes or other
injuries.

Wear good shoes for your walks. Make sure they fit comfortably and have a good cushion.
It is also important that the shoe's toe box is wide enough for your foot. If you
wear an orthotic (arch support), make sure it fits properly and always have it available
when trying new shoes.

Replace your shoes every six to nine months, or about every 250 miles. Walking in
worn-out shoes may lead to unnecessary pain and injury.

As you progress with your walking program, add variety so it does not become boring.
Change where or what time your walk. Find a partner to walk with. Alternate walking
one day with a different aerobic activity — such as bicycling — the next. This is
called "cross training."

Fitness classes are a great way to add variety to your fitness program. Try yoga,
tai chi, low impact aerobics, dancing, or cycling.

Most health clubs will have a pool available for swimming and water exercise. Water
exercise is another great way to start an exercise program, especially if you are
overweight and/or have joint pain. The water buoys you up and allows you to exercise
with less weight and stress on your joints. Many fitness clubs offer water aerobics
classes.

All aerobic activities should be followed by stretching. This will help you gain flexibility
and reduce muscle soreness. Being more flexible also reduces your risk for injury.

Stretching before aerobic activity may also help improve flexibility. Always warm
up your muscles before stretching. Five to 10 minutes of lower intensity activity
— walking, for example — is a good start. Additional guidelines for stretching include:

Stretch gently. Relax and breathe during your stretch

Hold each stretch for about 30 seconds

Do not bounce

Do not push a stretch too far; stretching should not be painful

If you have a back or joint condition, talk with your orthopaedic surgeon or physical
therapist about a safe, effective stretching program.

You can choose from a wide range of equipment to strength train, such as free weights,
rubber bands, weight machines, and even water-filled jugs.

Safe, effective workout programs can be found through organizations such as the AARP,
YMCA, YWCA, or your local health and fitness club. Joining a local health club can
be very beneficial when you are ready to spend more time on strength training. Many
health clubs offersboth free weights and exercise machines to help vary your workouts
and keep them interesting. Fitness professionals are onsite to provide guidance, and
offer classes to teach safe weight training exercises.

Core strengthening — working the muscles of your stomach and back — is important before
progressing to other strength activities. It is important to go slow, since it may
have been some time since you have used these muscles. Pilates is an exercise program
that focuses on core strengthening. Many Pilates exercises can easily be incorporated
into your resistance program.

More tips for effective strength training include:

Frequency. Work each muscle group (arms, legs, stomach, back and hips) twice a week. Do not
train the same muscle group two days in a row. Always give your muscles a rest from
strength training for at least a day.

Speed. Strength exercises are most effective when performed slowly. Move through the motion
smoothly — do not jerk or swing the weights.

Quantity. Do 8-12 repetitions of each exercise, working your muscles to fatigue. If you can
do 12 repetitions without tiring, increase your weight slightly.

You can add relaxation to the end of your exercise program or do it at a separate
time. Relaxation can be simple. Just sit with your eyes closed and concentrate on
controlled deep breathing. Yoga or therapeutic massage are other relaxation techniques
to try.

As we get older we tend to drink less water. Our bodies need eight 8-ounce glasses
of water each day. Caffeinated beverages, such as coffee and tea, do not count toward
hydration. They act as a diuretic and remove water from the body.

Eat your heavier meals earlier in the day. Try having a good breakfast and lunch
with a light evening meal. Eating breakfast suppresses appetite later in the day
for most people. Do not eat two hours before bedtime unless otherwise recommended
by your doctor.

Try eating smaller meals with a midday snack and midafternoon snack.

Consider taking a brisk walk before breakfast. This can "kick start" your metabolism
and help to burn more calories throughout the day.

Increase the fiber in your diet with a goal of 20 to 30 grams a day. Eat more whole
grain breads, lean meats, fruits, and vegetables.

AAOS does not endorse any treatments, procedures, products, or physicians referenced
herein. This information is provided as an educational service and is not intended
to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance
should consult his or her orthopaedic surgeon, or locate one in your area through
the AAOS "Find an Orthopaedist" program on this website.